[Place of coordination of complex pathways in oncology by coordinating private nurses]. / Place d'une coordination de parcours complexes en cancérologie par des infirmiers libéraux coordinateurs.

BACKGROUND: The complexity of the hospital-city care pathway is a real challenge because of the lack of coordination and communication between many stakeholders. As part of a call for projects from the General Directorate of Healthcare Provision, an experiment involving private oncology coordinating nurses was developed to address this issue. To our knowledge, there is no evaluation so far of such a protocol . METHODS: This single-center retrospective study focused on data from the ONC'IDEC program between 2015 and 2018, where 28 private nurses provided a 24/7 hotline. The objective was to qualitatively assess the coordination of this system. The nature and number of calls, patient satisfaction and medico-economic parameters were assessed. RESULTS: More than a hundred patients (n=114) were included in this device (mean age: 72 ± 12 years). The most frequent reasons for calls concerned the patient's general condition (35 %) and home treatment follow-ups (13 %) but also referrals to the primary doctor (4 %), which helped avoiding hospitalizations. The patients were satisfied with the experiment (overall score of 8.4/10). DISCUSSION: Thanks to the ONC'IDEC program, patients were able to benefit from more appropriate care through a privileged interlocutor by making their care pathway more fluid and avoiding hospitalizations. It would be interesting to confirm these results by means of a study with a higher level of evidence, by comparing this protocol to conventional hospital coordination.

Academic-Practice Partnerships: Update on the National Initiative.

The American Organization of Nurse Leaders and the American Association of Colleges of Nursing have been working together since 2010 to address how academic-practice partnerships can most effectively advance the profession by preparing a well-educated workforce. This article describes the work to date and future strategic priorities.

Medication Management in Municipality-Based Healthcare: A Time and Motion Study of Nurses.

The objective of this observational time and motion study was to increase our understanding of how nurses in home healthcare currently distribute their work time with a focus on the medication management process. The research was conducted in four municipalities in the southern part of Sweden. Participants were nurses working in home healthcare. The study measured proportion of time, comparison of proportions of time, proportion of time spent multitasking, and rate of interruptions per hour. Of total observed time, 20.4% was spent on medication management and of these tasks the highest proportion of time was spent on communications and dispensing medications. Nurses in nursing homes spent more time (23.0% vs. 17.4%, p = 0.001) on medication management than nurses in private homes. Nurses spent 47.9% of their time completing tasks with someone else, including patients, but had minimal interaction with prescribers. We observed a rate of 1.2 (95% CI 1.1-1.4) interruptions per hour on average and 30% of all interruptions occurred during medication management tasks. Nurses spent 3.7% of their time multitasking. Interruptions while performing medication-related tasks were common, as well as multitasking. Causes and consequences of the results need to be addressed in order to improve the safety of medication management for patients receiving municipality-based home care.

[The private practice nurse and environmental health]. / L'infirmier libéral et la santé environnementale.

Each day in France, more than 110 000 private practice nurses deliver care, in a context of the development of early discharge from hospital. Their role in environmental health is essential for the patient as well as for the healthcare pathway.

[At-home nursing care, challenges and perspectives]. / Infirmière au domicile, une évolution des compétences.

Private practice nursing is evolving in line with the major mutations taking place within French society and the health system. These evolutions require nurses to adapt to significant changes. Their clinical, cultural and organisational skills, in particular, enable them to face up to these challenges and to anticipate in order to be able to provide the best possible care in future. Private practice nursing could thereby become a speciality in its own right based on the World Health Organization's model of a "family health nurse".

[The coordination of caregivers in the patient's home]. / La coordination des intervenants au domicile du patient.

Home care is provided by different partners who may be self-employed in private practice, part of an association or employed by the hospital. For optimal patient management, all these caregivers, whatever their role, must collaborate while respecting the work of each individual. This collective consciousness requires the reorganisation of our care system to improve efficiency. Communication between everyone is essential.

Employee (Dis)Engagement: Learning from Nurses Who Left Organizational Jobs for Independent Practice.

Employee engagement is of growing interest in healthcare organizations. Engaged employees give an extra measure of effort to contribute to organization goals, whereas disengaged employees withdraw, have lower performance and are more likely to leave their jobs. The aim of this ethnographic study was, in part, to explore the reasons why high-calibre nurses became disengaged from their work and opted to leave their hospital-based employment in favour of independent practice, as well as to consider the organizational conditions that influenced their desire to leave. The findings revealed that nurses left their hospital-based jobs because of health system change, job characteristics, working conditions and lack of respect, which relate closely to the antecedents of employee engagement. Employee engagement can be fostered through organizational support, trust-building management behaviour and transformational leadership.

Advanced psychiatric nurse practitioners' ideas and needs for supervision in private practice in South Africa.

BACKGROUND: Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field. OBJECTIVES: The aim of this study was to explore and describe advanced psychiatric nursepractitioners' ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa. METHOD: A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch's method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature. RESULTS: The data analysis generated the following themes - that the supervisor should have or possess: (a) professional competencies, (b) personal competencies and (c) specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa. CONCLUSION: This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.

When the business of nursing was the nursing business: the private duty registry system, 1900-1940.

In the initial decades of the 20th century, most nurses worked in the private sector as private duty nurses dependent on their own resources for securing and obtaining employment with individual patients. To organize and systematize the ways in which nurses sought jobs, a structure of private duty registries, agencies which connected nurses with patients, was established via professional nurse associations. This article describes the origins of the private duty nurse labor market as the main employment field for early nurses and ways in which the private duty registry system connected nurses and patients. The impact of professional nurses associations and two registries, (New York and Chicago) illustrates how the business of nursing was carried out, including registry formation, operation, and administration. Private duty nurses are compelling examples of a previous generation of nurse entrepreneurs. The discussion identifies problems and challenges of private nursing practice via registries, including the decline and legacy of this innovative nurse role. The story of early 20th century nurse owned and operated registries provides an early and critical historical illustration of the realization of nurse power, entrepreneurship, and control over professional practice that we still learn from today.

Succeed from the start: a win-win approach for onboarding pediatric private duty nurses.

Providers and families that experience the service of pediatric home care nursing will attest it can be full of complexity and challenge. The logistics of making it all come together properly can be maddening and the emotional stressors involved can be exhausting. But when that ideal goal is reached and things do come together, home care services offer the reward and fulfillment that comes from knowing you're making a real difference in the life of a child and for his or her family.

Turning caring into business: the nuts and bolts of starting a private-duty home care business.

As baby boomers age and home care grows in popularity as an alternative to institutionalized care, opportunities abound for entrepreneurs to meet the demand through professional private-duty businesses. This article examines the nuts and bolts of launching and operating a successful private-duty agency.